I hear a symphony.

In the medical school lobby yesterday

My day yesterday was filled with little bombs of joy. Here and there. Some expected. Others totally unexpected. But altogether great in more ways than not.

The BHE took the kids to school and then came back home, sat at the kitchen table and chatted with me over coffee. Neither of us had any early "hit-times" (to use his military lingo) so this worked out great. And we talked about everything and nothing and we laughed and connected.

I looked around the clutter surrounding our kitchen table--Isaiah's scraps of paper from his backpack, Zachary's Van's shoe, some kind of Lego man, and some paper in a bag awaiting recycling. I didn't let it bother me. Instead I just enjoyed this man sitting in front of me talking about pollen on cars, the difference between kung fu and karate, and what it means to neighborhoods when a WalMart comes to town.

These are our conversations some mornings and some days I mostly do the talking and other days I mostly do the listening. On this day, it was listening and that was good because I love the BHE and am interested in what he has to say.

Later that morning my calendar reminded me that it was the birthday of one of my favorite Grady doctors--Mike L.  An esteemed senior faculty member with a heart as light and playful as that of a medical student. I make it a point to remember his birthday because I know it means a lot to him. So I called him up and said, "Happy Birthday, Pumpkin!" and he just laughed and laughed. It's funny that he always seems surprised that I remembered. I am learning that people like to be remembered. At least, I do.

"What birthday is this?" I asked.

"Sixty FIVE!" he replied with major emphasis on that "FIVE."

Now, of course, I felt bad about that because I am a birthday rememberer and should have noted that this would be a big year for him. Sixty five? Damn. So I gave him more effusive well-wishes and then sat there after hanging up thinking of something to do for him at the last minute.

Then I did this: I wrote a simple email to the members of our Grady division that said, "My life would never be the same if Mike L. weren't in it because if he weren't in it. . ."   I asked them all to finish that sentence and reply to all.

Next came an onslaught of over fifty one-line messages filling up his and our inboxes like a bouquet of flowers. All with funny, kind, witty, sweet words affirming why this person has been so special to us. And it made him happy because he told me so. But the secret is that it made me even happier to read fifty nice things from fifty nice people about one nice person. Yeah, people like to be remembered.

So that part of my day was really good.

I walked into the medical school to teach Small Group Gamma (aka "The Gammites") and had arrived about thirty minutes early. In I walked and immediately heard . . . . .music? Not just any music. Classical music. Swirling all around the building. Turns out there was a quartet playing in the lobby. An exquisite string quartet playing spectacular music just because.

So I sat down and listened and savored it all. And no, I am no big connoisseur of classical music but my mental iPod is always looking for new tracks and I think I may have gotten some. And. Mike L. loves classical music and the symphony so I felt it necessary to sit down and enjoy it just for him. I mean, it was his birthday and all. So I snapped these pictures and told him in a text message that I wished he were here because he would have loved it. And he agreed that he would have definitely loved it but that where he was at that moment on his 65th birthday was just as good if not better.

So that part of my day was really good, too.

Before going to teach the Gammites I stopped to chat with Mo M., who happens to be one of my favorite med students. She is mature and wise and positive so I always like seeing her. And this time I only saw her for a few moments, but that part of my day was good, too.

The Gammites were great as always. They taught me new things and made me laugh. Today they were doing the teaching on pre-assigned material and I had charged them to push to be innovative and interactive. This session blew my socks off. One student made an absolutely L.O.L. video about the affects of cocaine on the heart. L.O.L. but still educational. Another had us shoot baskets into the garbage can after answering questions about post-infarction pericarditis.

And I have to say that this part of my day was really good, too.

I had a few moments to kill after that session so jumped on line to catch up with emails, blogs and such. That's when I found out the good news that my blog-friend Sister Moon had just welcomed her second grand baby. A super juicy 9 pound 2 ouncer named Gibson. That made my day even better because I read her blog daily and was very much anticipating this delivery right along with many other people. It also made me smile to hear that he was 9 pounds and 2 ounces since my Isaiah was exactly the same weight. That said, I give much props to Ms. Moon's daughter, Lily, who (unlike me) pushed all 9 pounds and 2 ounces of that baby boy out sans epidural. Oooo weee.

Next I had a lovely chat with another favorite medical student--Jenna T. after our teaching session. She is  a fourth year student who just matched in Internal Medicine in Seattle--and who I've known and advised for some time now. We  walked and talked and laughed and even almost cried a few times. And that part was good. Very good.

Later that evening, the BHE held down the fort while I went to dinner with my Grady doctor boy-besties Jason S. and David M. Both are ridiculously attractive but weren't the least bit offended when I said, "You guys are like two outstanding accessories. I'm the best dressed girl in the room!"  And they just laughed because that's what you can say to your boy-besties even if it's totally sexist. Ha.

So I heard all about Jason S. presenting at a medical conference in Malaysia and David M. taking a trip to Egypt which was amazing. And they heard all about Isaiah making the winning soccer goal on Sunday which they seemed to be as enamored by as I was when hearing about exotic travels. And this was really good, too, because this is what friends do.

And today I am sitting in Jury Duty typing this post. Not exactly delighted to be here but quite delighted to see that they have free wi-fi so even that is good. Yes, it is.

You already know. I try to pay attention to what is good in my life. I don't ignore what is not so good but I do try hard to let the good overpower and drown out what is not good. This is my decision. At least today it is. And yesterday it was, too.

So yeah. Yesterday, I had a day that was filled with listening and laughing and loving. I had a day that unexpectedly took me to the symphony. And that day was good.  It was very, very good.

***
Happy Jury Duty Day.

Now playing on my mental iPod. . . . Ms. Ross singing the song that I can't get out of my head.

Go your own way.

You can go your own way

Go your own way

You can call it

Another lonely day

You can go your own way

Go your own way

~ Fleetwood Mac 

________________________________________

Decisions. So much in life is just decisions. Even the things that happen without your permission--at some point--depending upon how you choose to deal with it, have outcomes that come down to our decisions. From the big things to the small things and all the stuff in between. Right now, I'm reflecting on it all.

Something crappy happens. So you make some decisions.

Do I curl up in a corner and wither away feeling sorry for myself?
Do I fill my body with so much anger and rage that it comes exploding from my mouth in the form of colorful expletives?
Do I get all surly and sarcastic, saying things like "Life's a bitch and then you die?"

Eh.

Guess it all depends upon what you decide.

Yeah, so I'm not thinking of anything particularly deep at the moment. I guess I'm just reflecting on the last few days and just thinking. Thinking about decisions and free will which, I guess, is kind of deep if you think about it.

Or if you decide to think about it. Ha.

Anyways.

I saw this dude in the clinic today who used heroin for "more years than you even wonna know." He'd dabbled in crack cocaine, smoked a little reefer here and there, but none of them made him feel as good as the "herr-aahhn" did. But the thing about it is. . . he'd quit using it. The heroin--he'd quit altogether. Yes. That and everything else except for cigarettes. And that's how we even got on the subject because I was talking to him about quitting smoking and he said:

"I'm still thinking about it."

And for me, that was cool because that meant he hadn't decided to quit yet. Or rather he had decided that he still wanted to keep smoking. But in that same breath he told me about how when he was ready, he would quit just like he quit herrr-aaahhn and all that other stuff he did on the side.

"How did you quit the heroin?" I asked.

"I just decided I was done with it," he replied.

Which made sense to me. So next, I decided to ask him one more question to see if I could get him closer to deciding to quit the cigarettes, too. Especially since he had some horrible medical conditions that were being made horrifically worse by his tobacco use.

"Sir, how are things with your nature?"

My resident with me looked puzzled and that patient sounded puzzled when he said, "My who?"

But see, the patient was just surprised, not confused like that resident doctor.

"Your nature. Do you have troubles getting erections?"

And he narrowed his eyes at me for a bit and then decided to be honest. "My nature ain't been right for a minute now."

So I just shrugged and said, "Okay. Well smoking can hurt the blood vessels that help you get a hard-on."

And my resident's face flushed at that term which, yes, I had decided in that instant to use because it was graphic and I was going for graphic. And because I'd decided that in this situation, too many other words would have just been a waste of airspace.

That man told me that hearing that made him think and that just maybe, he'd decide on a quit date real soon. And I told him that I was cool with that, too, because I was.

Because it was his decision.

Another lady was overlooked in the waiting area today. We didn't get to her appointment until two hours after she'd arrived which was NOT cool. So as soon as I entered her room, I was profusely apologizing. She looked at me just as peaceful as ever and said, "It's alright. Not alright where my time ain't precious, but alright where we can move on. I accept your apology and appreciate it."

And next she pulled her pill bag out of her pocketbook and prepared to keep it moving.

"You are so peaceful," I decided to tell her.

And she replied, "Being pissed off and angry is a decision."

I told her, "Yeah, like I heard somebody say, 'Being angry is like you drinking poison and expecting the other person to die.'"

She laughed out loud. "You got that right!"

And that was that. So we decided to get to why she was there instead of fume or fret or whatever we could have done for the rest of that visit.

Yeah. So that was that.

Then, toward the end of my crazy busy day in clinic today I got this text from Harry that said:

"Don't forget I am going to the Hawks game tonight."

And the truth? I can't be sure if I forgot or if I didn't really know ever. So I furrowed my brow to contain the ripple of irritation that rolled over me before preparing my thumbs to text back.

"Uuhhh, hello? When did we talk about you going to the Hawks game?"

But just as I started to push send, I paused. I wondered the point of my response.

Was it to make him feel bad?
Was it because I didn't want him to go?
Was it because I felt annoyed at some kind of social thingamabobby planned on a Monday?
Was it to punish him for not re-reminding me before two hours before the game?

That's when I deleted that text and decided on a different approach. I answered those questions for myself.

Did I want to make him feel bad? Uhh, not really.
Did I not want him to go? Honestly, it wasn't really a big deal on this night.
What about the social thing on a Monday? Eh, not really so bothersome now that I thought of it.
Was I trying to punish him? Sheesh. I hope not.

I realized that if I sent that text, it would just mean that I was deciding to be an asshole. Plain and simple.

See, the day before, Harry had spent the entire day with our boys. Soccer practice and soccer games and then he even grilled for them. The day before that, he had Isaiah's best buddy over for a play date and later had a "boys' night" with just him and the kids which involved dinner at Chili's and ice cream from Breuster's. All while I was off doing the things I wanted to do like go to a MOMO-CON-slash-Delta Ball, have a fun reunion dinner with my college sorority sisters, and even get a pedicure.

So the thing I realized by pausing is that in the grand scheme of things, I am not married to a selfish person who disregards my time. My next decision was this text:

"Great. Drive safe and have a great time."

To which he replied:

"I love you so much."

Which I have decided is much better than what would have surely become a passive-aggressive exchange without any point.

All because of a decision.

So yeah. I guess I'm just rambling because the simplicity of this concept astounds me. So much rides on free will and decisions.

Which also reminds me:

I heard Harry lecturing the kids on Saturday about making good decisions. He was saying it in that stern-daddy way but now that I think of it, it was a good word.

"You are responsible for your decisions. You've got to make good decisions, sons."

And yeah, he was really talking about their decision to get soaking wet and muddy in the backyard when they'd been specifically told to not go near the creek out back. But still. He was schooling them on the same things that made that patient put down that herrr-aaahhn or that lady who'd waited for two hours not tear me a brand new you-know-what.

And you know what else?

I have some friends whose hearts have been broken by disappointing decisions made by their significant others. Feeling broken and angry over all of it but deciding over and over to try hard to be strong. Making a decision not to live in crippling bitterness even though they'd be well within their right. A decision to not drink that poison because it's clear who dies when that happens.

Yeah.

I guess it's all kind of like Fleetwood Mac said in that song. At the end of the day, no matter what is being dished to you or done for you, you can go your own way. And damn it, when Lindsey Buckingham and Stevie Nicks sing it, I really believe it.

Whoa. Now that was some real rambling. But I decided I needed that tonight. Hope you don't mind me unpacking--but then you may have decided to stop reading three paragraphs ago.

The take home?  If there is any, I guess it's this:

How we live is based upon decisions.
How we love is, too.

***
Happy Monday.


Now playing on my mental iPod. . . .The song Lindsey Buckingham wrote as a message to Stevie Nicks. Interestingly, they decided to still make this record, even though their love had unraveled. Just look at Stevie's and Lindsey's faces on this video.  It's a trip. . . .decisions, decisions!

Going Gaga.

I went to this really swanky ball yesterday for my sorority. And let me tell you--it was lovely. The room, the centerpieces, the decorations, the occasion. . .the everything. Plus, all of us Delta girls wore red gowns, so there was like this sea of red ball gowns in the room.

Just gorgeous, I tell you.

But here's something funny--how 'bout there was ALSO some kind of anime (you know--like the Japanese animation?) convention called "MOMO-CON" going on in the very hotel where the ball was being held. Yeah and pretty much in the same atrium.

So in addition to the sea of lovelies in red gowns, there was also this going on:

Like in the same space. No, I'm serious.

Don't understand what I mean? Okay, well it was like this picture. Except instead of being cartoons, there were like real humans. All dressed up like these cartoon characters. Yeah! Walking around. Right next to the red ball gowns and custom-fit tuxedos.

Heh.

Now some folks weren't too happy about all of that. Which I totally get if you spent several months on the committee planning such a fete. I mean. . .who wants a furry unicorn and a blue-haired girl with Hello Kitty's head standing at the bar next to your swanky guests?

Errr, yeah.

Okay, but here's my confession: I loved it. I thought the dichotomy between the two groups was pretty doggone amusing, quite frankly. And, I was kind of digging the whole Lady Gaga-ness of those anime convention costumes. 


Wait--hold your horses, people. I don't mean "loved it" to the point of putting "ANIME CONVENTION" on my bucket list. Uuuhhh, not so much. But it did make for some awesome people watching.

Yeah, so these folks had gone ALL OUT for anime, like for real. And all their "all out"-ness was right up in our straitlaced personal space. Crazy! So the whole thing? It was just so weirdly cool. Okay, okay. Maybe it was more weird than cool, but so what. It was definitely blog-worthy, that's for sure.

This costume was my favorite. Isn't it like totally Gaga?

Now the best part was  how "normal" the girl was in that costume. Talking to her was like talking to any seventeen or eighteen year old girl. Seriously. She complimented my dress and my hair -- "Like OMG, that dress is so fab." Then I complimented her star-spangled skirt and multi-spiked paws -- "And girlfriend you are killing it with that costume!" 


See? Totally normal, I tell you.

Man. So glad I took that picture. This will amuse me every time I see it, I just know it.

And the point of this post? None whatsoever.

Wait. I take that back. The point is that you just can't ever take yourself too seriously. Ever. And that you have learn how to lighten up and enjoy what's going on sometimes.

Even if what's going on seems kind of furry, fluorescent and weird.

Oh, and I just thought of one more point. Really weird looking things can be totally normal when you explore a bit closer. And those normal looking things? They can turn out to be totally weird once you learn the real deal.

I'm just sayin'.

Yawn. That's all I got, man. Night night.

***

And of course on my mental iPod. . . a little bit of Gaga for all you little monsters out there.

Zoom.

 Oh Zoom

I'd like to fly far away from here

Where my mind is fresh and clear

And I'd find the love that I long to see

Where everybody can be what they wanna be

~ The Commodores "Zoom"

_____________________________________

"Tell Patrick to shut that screen door!"

I nervously rearranged the covers over Ms. Abner since I couldn't meet that request. First of all, there was no screen door in this hospital room. And second of all, I wasn't fully certain who Patrick was.

"Hi Ms. Abner. It's me, Dr. Manning. I'm just here to see about you and check on your bladder infection, okay?"

"Somebody told y'all to come over here and I didn't want all that. I still got to write out bills."

I stared into Ms.Abner's eyes and searched for something, anything that would even our playing field. A glimmer or flicker to let me know we were in the same place. But we weren't.

You see, Ms. Abner had been robbed. Slowly and ruthlessly robbed. Not in that way where someone kicks in your door and ransacks the place for everything at once but in that way that takes some time to realize. A piece of jewelry here. A couple of dollars there. Until one day you look up and realize that just about everything you really cared about is gone. With the exception of the heavy furniture.

And yeah. Technically, robbery suggests that something is being taken by force. But in my mind, any time someone loses their precious memories and cognitive abilities, it has to be by force. Even if it seems sneaky like a pick pocket, no matter what anyone says, it's still brutal like robbery.

Yeah.

So, Ms. Abner had been robbed. Over and over in broad daylight with everybody at home.

Her eyes were so vacant. Off in some far away land with people named Patrick and swinging screen doors. And the hardest part was that she wasn't even seventy years old yet.

"You're looking a little better today, Ms. Abner. Your blood pressure is better and your fever seems to have broken."

"Do she know how to get there? Somebody need to give her directions, don't they?"

"Beg pardon, Ms. Abner?" I reflexively asked.

Zoom.

Just like that, that idea was gone, too. Now it seemed like the heavy furniture was being lifted right along with the silverware.

I looked down at the blanket dutifully strewn over her shoulders. A lovely leopard-printed fleece that clearly wasn't a Grady issued item. Her face had been scrubbed clean and covered with what looked like Vaseline. The thinning gray hair on her head was tightly plaited into cornrows. It was obvious that someone loved her.

Next I saw a note taped to the bedrail:

"My mother Ms. Lola Abner is very cold-natured. Please keep cover on her shoulders even when it seem like the room is warm. Also if you take off her socks you need to put them back on her feet because she get cold. ~ Signed, Angela Campbell (her daughter)."

Written in careful cursive with love in every swirl. Followed by two phone numbers in big block letters, just in case that note wasn't clear. And so, I did exactly as that meticulous note suggested. I checked to make certain that her body was fully covered with her blanket and that her socks were on both of her feet. One was off so I replaced it.

She stared out of the window speaking in disconnected sentences. I watched her, trying my hardest to see the person that I am sure she once was. The one before the thievery and the vacancy.

"Ms. Lola." I spoke her name quietly while patting her cheek. She turned her head in the direction of my voice. I repeated myself. "Ms. Lola, Ms. Lola, Ms. Lola."  

And that seemed to be something that the robbers couldn't move. Her name, Lola.

So I just stood there saying her name. And each time that I did she responded. She even smiled--at me. Not just in my general vicinity but truly at me, this person who was speaking her name. I wanted to see who she was so badly. This was the closest I could get.

And so. For the rest of her hospitalization this is what I did. I talked to her doting daughter about the details of her condition. Then I told Ms. Abner the plan -- whether she could hear me or not. And last, I just rubbed her dewy skin with the back of my hand and murmured her name.

"Ms. Lola."

And that always seemed to even the playing field.

On the day she was being discharged, I stopped by the room to see her. Ms. Abner's daughter, Ms. Campbell, was there fussing around her bed getting things ready. Once she had everything packed up in the plastic bags she sat on the chair and sighed.

"Did Patrick get what I told him to pick up from the store?"

Ms.Campbell reached down and tightened the draw string on the bag. She didn't look the least big fazed. "Mama, Patrick is gone, remember baby? But I got all the stuff you like at home from the store, okay?"

"It's weeds all out in that flower bed. I don't know why nobody don't just pull 'em up. A little bit every day so they don't get overgrown."

"Mmm hmmm, okay Mama. We gon' get you out the hospital today, okay baby? You doing better, Mama so we gon' get you on home." She looked over at me and pressed her lips together for a moment before speaking. "A nurse is going to get us discharged, right?"

"Yes, ma'am," I answered.

"Okay, good. Thanks, hear?"

I smiled and just sort of stood there thinking of what to say next. Ms. Campbell was on to the next thing and barely seemed to notice the pregnant pause.

"Umm, Ms. Campbell? What questions do you have for me about your mother?"

"Oh, huh?" She looked up from her pocketbook. She had already moved on to throwing out the old receipts and scraps of paper cluttering her bag. "Questions? None, sweetheart. We okay."

"Oh, okay."

I waited a few more seconds and then spoke again. I hoped I wouldn't regret that next question, but I just had to know.

"Ms. Campbell?"

Without glancing up from her purse she answered me. "Ma'am?"

"Who is Patrick?"

This time she stopped what she was doing altogether. She smiled and let her ample chest rise again with a big breath inward. "Patrick? Patrick was her baby brother. She loved him so much."

"He passed on?"

"Yeah. . . .an accident on the job when he was only in his twenties or so. I was just a little girl when he went home but I swear I feel like I know him. She always speak of him."

I nodded and kept my eyes fixed on her daughter. "Wow."

"She loved Patrick so much. Mmm, mm, mmm. That was her heart."

"You can tell," I responded. Then I chuckled and added, "Even if he left the screen door open."

Ms. Campbell threw her head back and laughed out loud. She glanced over at her mother and said, "Mama, you still on that screen door? Lord have mercy!"

And that laugh was easy and gentle but laced with some pain. I think I sensed it because right after she said that the room fell awkwardly silent. I bit the inside of my cheek and watched this woman who could not have been even ten years older than me. I imagined my own parents and loved ones and siblings and tried to get my mind around that laugh laced with angst.

I couldn't.

"Do you . . .miss her?"

Ms. Campbell squeezed her eyes together tight, almost like she was trying to literally create a dam to hold back tears. She shook her head and sighed again. That same big, bosom-raising sigh. "Every day," she finally said. "I miss my mama every single day."

"Mmmm." That was my response. It wasn't much but it conveyed a lot I hoped. Like, I bet you do miss her, or I don't know how you do it, or I bet you she misses you, too.

"It's hard because sometime she look at me dead in my eyes and seem so much like herself. And she say something that sound just like the mama that raised me and I do everything I can to keep her in that moment. But then just like that, she gone again. This almost worse than having her gone altogether. I think that sometimes. One minute she here, then she gone."

Zoom. Just like that.

"I'm sorry."

"Sometimes I am, too. But not for myself. She still my mama. It's still her. Deep inside I know that."

"Yeah," I said back, almost under my breath. Then I spoke up. "What was. . .she like? I mean before?"

Ms. Campbell's eyes lit up and then floated away into another time and place for a moment. "My mama was bossy. And opinionated. And a cook? Girl, what you talkin' 'bout! But she was a mean cook. She wouldn't give nobody her secrets and didn't like nobody in her kitchen when she was cookin' neither. And she didn't like nobody swingin' no screen doors in her kitchen letting flies in. Wheeewww, you want to see her mad? Open that screen while she cooking." She laughed again. But this time without the pain. "And she was a good mother to us. She took good care of us. It's six of us and she treated us all like we was the only one."

"Wow."

And after that, there wasn't much more to say. I moved toward the bed and studied Ms. Abner's face. I searched her for that person that her daughter had just painted. Instead of her frail and atrophied body, I imagined her able-bodied wiping her hands on an apron in her kitchen. I pictured her scolding children for swinging screen doors and seating them at a wooden table to say grace in unison over food she'd prepared with love. I even let that image include a young Patrick, strong and muscular, wolfing down a plate that she'd placed warming in the stove for him, her beloved younger brother.

"Ms. Lola, Ms. Lola, Ms. Lola," I whispered to her one last time.

Again she turned toward my voice and gazed right at me.

And for the first time, I think I truly saw her, too.

***
Happy Sunday.

Now playing on my mental iPod. . . .Zoom. Damn, I love to hear the young Lionel Ritchie! 

Match Day.

Captured in the crowd ~ me celebrating with my advisee, Antoinette

Seeing the students that you've known and taught since the very beginning of medical school opening their envelopes on match day just never gets old. 

Ever.

But especially the ones that you love.

Ant from Small Group Alpha

This one? I love so much that I can't even write about it. So I won't. Because I'm so proud and so full that I can't. So I won't.

I'll just say this: Congratulations, sweet girl. You have left me forever changed. This world is yours.

Gracias para todo.

Dr. M

***
Happy Match Day to all. And to all a good life.

Reflections and ramblings on an awe-some day.

Anand B. M1, yesterday at Grady.

"Now a good friend of mine

sat with me and he cried

He told me a story

and I know he ain't lyin'

Said he went for a job

and Mr. Man said

Without an education

you might as well be dead."

~ James Brown

________________________________

Yesterday, March 13, 2012.

The day started so early. Even though it was only 5:30-ish when I woke up--which is the time I often wake up--still it felt so. . .early. Oppressively early, even. The time had changed but still I had not. So when that alarm went off, there was no pep anywhere to be found in my step. Nor was there even the tiniest hint of slide in my glide.

Anyways. I wasn't in a bad mood or anything. Just tired, really. And there is a difference. On this particular day, I had an early meeting on the Emory campus. This meant that I would need to go to Grady and round even earlier. Mix that with being up waaaay too late working on a presentation and feeling like you had one hour robbed from you and it all adds up to some major exhaustion.

But this day wasn't so unusual. I have days like this where things get all crammed together and crazy. I told my friend (and fellow Grady doctor) Wendy that I thrive in this kind of crazy. So as I was sitting up the night before gritting my teeth and bitching/whining about deadlines she quickly reminded me of that little fact about myself. I guess it's kind of like how some things grow best in certain climates. Or better yet how some bacteria get mightier given the right medium. And I know Wendy gets that analogy about me, partly because she's my friend but even more because she is an Infectious Disease Grady doctor.

So yeah, I thrive under pressure like Group A strep thrives on skin and mucous membranes. Um yeah. Kind of like that.

So I go and I round at the crickety-crack with the twinterns and Elicia, the fourth year med student. And it was good. Very good. They are like a well-oiled machine and they know how and when to stamp out disease. So, yeah, we rounded like gangbusters and connected with our patients and laughed and learned and all the good stuff that you do when you get to work in a place like Grady Hospital.

Next, I hightailed it over to my meeting. That presentation that I was gritting my teeth over was also one that Wendy was a part of, too. I was the one making the slide set the night before because I had the not-so-bright idea to use this fancy, shmancy presenter tool called Prezi that I'd recently heard about. (Actually from Wendy, now that I think about it.) Anyways. Being the master-procraster that I am (yes, Mom, I meant to say "procraster" not "procrastinator" because that doesn't rhyme with "master") that meant burning the candle at both ends.

But. We gave our presentation and Wendy was amazing and I was just alright but all of it was acceptable and well-received. And that was good.

Back to Grady after that and this was when I first started to feel that 5:30 that felt like 4:30 jumping on me. The sandman was trying as hard as he could to send me a dream as I sat in my office eating a sandwich. Finally, I just gave in and took a quick power nap at my desk. Sure did.

Next up, medical student teaching. I decided to ask my first year small group if they wanted to join me at Grady for rounds. They were down for it, so after my power nap I joined them, along with my all star 4th year student, for some fun on the wards. The plan was simple. We will go and see patients. You will talk to them and hear their stories. Together, with their permission of course, we will perform elements of the physical examination. If and only if the patient is agreeable/not tired/there/awake/not in pain.

And you know what? There are some really wonderful people out there. Wonderful people who, even though they are hospitalized, are down with having a little piece in the pie of training up a young physician in the way that he or she should go.

The best of those was this delightful Grady elder who, hands down, is my F.P. this week. He told his story carefully and was happy to do it three separate times.

"Anything for you, doc," he said. And he meant it which I appreciated.

So I came in there three separate times and each time he was graceful and kind and giving and wise. Those students watched and listened and learned from him and soaked up all that he had to give. And he had so much to give. Yes, he did.

"Any advice for these young people?" I asked him.

He smiled and folded his arms behind his head on the pillow. He looked skyward and then said, "You know? I see it in they eyes. They want to do well. They want to get it right. Jest don't let that go. No matter how far along you get, don't let that go."

And they nodded and listened and you could just tell that they took it to heart. Me, I felt like crying. So I told him just that. "Sir, you're about to mess up my drug store mascara!"

And he laughed as did the students while I patted my Maybelline before it turned into scary raccoon lady eyes.

Then he added one more piece of advice for the students:

"Remember what James Brown said. Don't be no dropout."

And the students stared and looked puzzled so he clarified.

"Get yo' education. Without your education, you might as well be dead."

That room fell silent after he said that. For a lot of reasons. One because those students had never heard that song but more because that F.P. of mine was telling them to go and do something that he never could.

You see, just two minutes before, he had explained to them, while telling his story, that he never went to school. Well, take that back. He did "the first" and "a little bit of the third." But otherwise he didn't go to school and nobody had an issue with that back then. He was being raised by his grandparents and was expected to work in the fields and help out. No time for anything else. Period. Done. End of story.

So school wasn't an option for him, but today, he took those students to school, do you hear me? You better believe he did. No, he "don't read no more than jest knowin' my name on a pill bottle" but that doesn't mean that man wasn't qualified to be a teacher.

And best of all--those students recognized that.

We were all in awe because he was just that--awe-some, for real. Not in the "like totally" way but in the real, true sense of the word.  His laughter, his advice, his patience, his everything. He had so much to teach us.

I mean. . . this functionally illiterate man with real, true medical problems who had (literally) hoed some hard rows in his long life still had a song in his heart. A beautiful song on his lips that he shared just like birds chirping high up in the trees for any and all to hear. And if that doesn't teach somebody something, I don't know what else will.

Today I am reflecting on the exceptional and unselfish collection of teachers that I encounter in Grady Hospital every single day. I am feeling thankful for their words and their stories and their patience. I am blinking away tears as I imagine all that so many of them are up against but still--STILL--they take the time to teach us all every single day.

And of course, there are days that they just aren't up for it. And that's cool because I'm not up for everything every day either. But the thing is. . .most days they are up for it. They are. Not in that way like a person who doesn't have a choice. No, not that. Grady Hospital just happens to be filled with its share of gracious human beings who somehow realize that all of it is bigger than they are. . . because it is. All of it.

Sigh. I'm rambling. I know.

You know? It's just that my day yesterday was good. It was rich and powerful and so full of grace. All of it. And yes, I said it once hell maybe even twice --- I'm so, so grateful. Just so grateful to be a part of something so much bigger than me. So thankful that I was there to hear those words with those students in that moment in that room.

And now I'm full-on crying--scary raccoon lady eyes and all--because I really, really feel that way. I truly do.  About all of it and everything and those students and that sweet, sweet man and my friend Wendy and just all of it.

Because this? This is Grady. And man. . . . .I'm just glad to be here.

***
Happy Wednesday. Oh, and don't be a drop out.


Now playing on my mental iPod. . . . .courtesy of my F.P.

Full Circle: Intern Year Check In.

Okay. I am having a bit of writer's block-ito. So here's a lovely check in from my class of 2011 student advisees who are all hard at work in their internships. (Antoinette is missing from this post--she is graduating this year and starts internship next year! Stay tuned for match day -- coming up this week!!)

And away we go. . . .

Sweet Alanna hard at work in San Francisco. That smile on her face? It's because she's doing something she's been waiting a long time to do.

Well. Talk about full circle. Dougie happens to be an intern on my team this month and let me tell you. . .it's an interesting experience. I liken it to having your own son. . or rather nephew. . .on your team for a month. Weird. . .but in a good way.

Man. Remember when I went to his wedding and cried like a baby? Man. Seems like yesterday.

See, I've known Doug since his very first day of medical school. I mean from the very, very first day. Hell, I've known all of them since then. But this month I'm literally his attending. And he is my intern. So this is kind of crazy for me to see.

Crazy, yes.

But also? Majorly pride-inducing. He is a kick-ass intern and you know? I can't even front like I don't feel like I had something to do with that. Ha! Mostly I'm proud to see him growing up. I'm more proud of that than of me for being there for the ride.

Hreemy! Oh, how I miss her! Chicago seems to be treating her well. I'm so glad I will officially have an ophthalmologist in the family. Lord knows with these eyes I need it!

She passed through town a few weeks ago and we had breakfast. I'm so glad that with one day in town she wanted to meet with me. That was really touching to me.

Jin sent this super funny snap this week of her on call. Looks like she was well stocked up on caffeine! I just hope she had a catheter in her bladder, too! :)  Jin is up in D.C. taking care of America's heroes. She's as awesome as she looks in this picture.

Yes. Tony is as funny as he seems on this picture. I wish I could copy and paste some of the hilarious and tearjerking emails and messages he has sent me chronicling his internship so far. It's just too much to put here. But let me tell you-- he calls me and writes me and he shares those moments on my voice and e- mail. And I deeply appreciate it that he does.

And this guy. Sigh. I've always called him Sparky (a nickname he got after a particularly . . .interesting. . .haircut he once arrived at small group with) but the name has stuck. At least for me. He is the most stoic of my group but has always been the one who could make me cry on the drop of a dime.

Case in point:

*clutching chest*

And this is why I have the very best job in the entire world. Yes, I do.

***
Happy Sunday.


Bonus snap:  Me and fellow Grady doctor Danielle J. in a pic taken today-- after working at Grady all weekend! We are pouting but right before this photo we were both talking about how awesome it is to watch our learners grow.

(By the way:  I met Danielle J. on her first day of internship. And. I was her ward attending during her residency. Now here we are as colleagues pseudo-lamenting about working on a cloudless weekend in Atlanta. )

Consider this.

MIchael Stipe singing "Losing my religion."

"Consider this

The hint of the century

Consider this

The slip that brought me

To my knees failed

What if all these fantasies

Come flailing around

Now I've said too much

I thought that I heard you laughing

I thought that I heard you sing

I think I thought I saw you try

But that was just a dream

That was just a dream

That's me in the corner

That's me in the spotlight

Losing my religion

Trying to keep up with you

And I don't know if I can do it

Oh no I've said too much

I haven't said enough"

~ from R.E.M.'s "Losing my religion"

_____________________________________

Ahhh.

Oh, how I love this song. So much. It's such a haunting song, you know? I love that the song writer has never really been clear on what it means. Like, is it really literal? Like has something literally made him lose faith? Or rather faith in his Faith? Or how about in someone? A regular someone? A deity? Or none of that at all?

Hmm. 

Yes. I'm of Christian faith. But I still love this song. So much. Mostly because I think it has nothing really to do with organized faith. Or any of those things that the talking heads in the primaries are fighting over. Which interestingly aren't things that intensely matter to me, a person who also happens to be down with Jesus. And even if it is literally about organized religion, so what. It makes me think. And thinking is good. Even for people who are believers in assorted faiths.

Anyways.

I just think it's such a layered song. With such a bold title and hook. That mandolin, that pleading in the vocalist's voice. It punches me in my chest and makes me stop what I'm doing and think. And wonder what it means.

And you know? Every single time I hear this song, I think of a new meaning. That's what makes me love this song so much.

I love things that can have many interpretations. Don't you? Because I think life and people and everything are like that. Open to many interpretations. Changing interpretations, too. Remixes and revisions and redemption, too. Kind of like my take on this song every time I hear it.

Some days I can even relate this song to my writing here. Like, I say to myself after hitting publish: "Oh no, I said too much." Or even, "That's me on the corner. . . .that's me in the spotlight . . . .losing my religion. . ."

Then I will feel a pang of fear. Like I revealed my clay feet or zoomed right in on my Achilles heel for the whole world or rather, world-wide web, to see.

But like Michael Stipe who wrote those words, that hint of fear somehow bolsters my fearlessness. It makes me want to be transparent and to write things that make people think and feel and even come back to read again. For a new take. A new interpretation.

And to be a little more okay with their own clay feet.

Zachary heard this song playing on my computer and came over and sat on my lap. He sat there quietly listening and watching and seemed mesmerized by the mandolin and Stipe's voice. Then when it ended he looked over at me and said, "Can you play it again?"

And I did.

this morning in my kitchen

We sat together and watched that video all over again, too. And he watched the images and asked me questions like, "Do you think that man is an angel?"  And I said, "I don't know. Do you?" And he looked and said, "I think he is. Maybe he is trying to cheer the singing man up."  "Hmm. Do you think he seems sad?" I wanted to know. So he told me his thoughts. "He seems like he lost a friend. And like he feels sad about it." And I looked and watched some more and that little five year-old observation opened me up to yet another interpretation of this song.

Maybe he lost a friend. Or faith in one. Or himself. Or something.

I don't know. I just love this song. And what's cool is that now my five year-old child does, too.

The official video used to be un-embeddable. But hey! For some reason, it can now be embedded. So until someone blocks it, here it is. The original video to "Losing my religion" by R.E.M. that my friend Ms. Moon says is the reason videos were invented.

And I think she is right.



Do you love this song, too? What's your interpretation?

Or better yet.

What other song does this to you? Makes you think and wonder and try to interpret over and over again? Maybe I haven't ever heard it. But I'd love to. I really would.

That's all I've got for now. What you got?

***
Happy Saturday.

Hurry up and wait.

image credit

Slow down, you movin' too fast.

You got to make the morning last.

Just kicking down the cobble stones.

Looking for fun and feelin' groovy.

~ Simon and Garfunkel "59th Bridge Song"

______________________________________________

I was holding a patient's hand yesterday. She was the last person I was seeing on rounds that day and it had been a long day. I was feeling over-scheduled and over-tired and over-everythinged. The clock was on my back and the list of things I had to do at home was just as long as the one I had finally finished at work.

I needed to go.

It was already 5:20 P.M. The sun was already on a downward descent and late afternoon sunshine was peaking lazily through hospital blinds. And today, there wasn't much going on with her so I felt confident I could get out in time to get both kids on time.

If I hurried, I'd be just fine.

There was a procedure that she'd needed and that procedure had been done. She'd tolerated it well and all of the teams of physicians caring for her were now working in a lovely three part harmony. Plans clear. Clinical course, at this point, predictable.

This was supposed to be a quick in and out visit. A chance to check on her pain and see if she needed anything. What would work best for my schedule would be for her to say, "Nope, I'm good" or even ask one obligatory question to which I could quickly answer.

Not so fast.

"Hold my hand," she said. She was telling me more than asking me, so I sat down on the edge of her bed and did what she said.

"You okay?" I softened my voice to let her hear my concern. And to hide my ticking time clock.

"I'm fine. I just want you to hold my hand for a little while that's all."

What? But. . . 

"Okay," I answered. "I can do that." Because even at 5:22, I could. At least for a moment.

So I held her hand and waited for her to say something but she didn't. She just sat there watching Judge Judy and not even looking at me. The silence was killing me so I made some small talk.

"Are you moving your bowels okay?"

"I am." She nodded her head while saying that. Keeping her eyes on Judge Judy.

"Any pain?"

"Just a little. But the pain pills help mostly. So mostly no pain." She shook her head. Back to Judy.

"Okay."

I softened the grip on her hand and she sensed it as the warning that I was trying to leave. Her fingertips pressed into the back of my hand.

"Don't go. Can't you just stay with me for a little while?"

Eyes off the television and now on me. I didn't respond. Instead I just sat still to show her that I'd try to stay a little longer. Even though I really needed to go.

Like, for real.

I looked into her eyes. They were unusually wide like brown saucers.

"You sure you alright?" I finally said.

"You know? Nothing is wrong right now. I just like you. I like your voice and how you look at me. It makes me feel better for some reason."

My face immediately grew hot.

"I like you, too." That was all I could think to say. But at least it was true.

After a few moments, she let my hand go. Then she said, "I know you got to go. You probably got to go on home or see other patients and I know that. I can tell you a busy person. But you know what? You got this special thing about you that don't make people feel rushed. Even when you in here quick it feels like you got time for me."

Wow.

I sat there speechless. I thought about how many times this week I'd already told my kids to "hustle up."

"If you feel rushed I guess it don't even matter if it's not a rush," she added.

I thought about the last thing I'd said to Isaiah as he dawdled that morning before school. "Come on, buddy. Sense of urgency, bud, let's go. Hustle up." Even though we were making good time this morning.

Yeah, hustle up.

"I guess perception is reality."

She looked over from Judge Judy. "What's that, Miss Manning?"

"Just what you said. What it seems like might as well be how it is."

"Yeah."

"You know what? I was kind of in a hurry when I came in here. I can't lie."

Now she was off of Judy for good. She smiled at me sideways.

"But you didn't make me feel like that, see."

"Hmmm."

I squinted up at Judge Judy and then looked back at her. The verdict was just about to be rendered. This let me know that it was very close to 5:30.

And that I still needed to go.

"You know? Some days I'm pretty sure I don't get it right."

"Today you did."

I grabbed her hand again and squeezed it. "Man. I kind of needed that today. You must have sensed that I did."

"No, Miss Manning. . . you know. . . actually I didn't."

"Well, it seemed like you did." We both chuckled.

"So what it seem like might as well be how it is. Right, doc?"

"Right, indeed."

I paused for twenty more seconds after hearing Judge Judy bang her gavel. Judgement for the plaintiff. The credits started to roll and a commercial came on.

"Alright then, Miss Manning." She gave my hand a pat of dismissal.

I stood up to leave and headed toward the door.  I flicked off her light switch and replied, "Alright then."


***
Happy Friday.

Now playing on my mental iPod. . . . 

Glitter-sparklies.

Zachary:  Mom!

Me:  Zachary!

Zachary:  Whoa! You have even MORE glitter-sparklies in your hair! 'Specially in front!

Me:  That's gray hair.

Zachary:  I think it looks like glitter-sparklies.

Me: What do you think?

Zachary:  About what?

Me: About my glitter sparklies. Do you like them?

Zachary: Mom, I like everything about you.

Me:  *swoon*


Verdict:  From now on, it's not gray hair. It's glitter-sparklies.


(P.S.  Am I the only one who isn't sure about "grey" versus "gray?"  Please advise.)

***
Hope your Thursday sparkles.